Aterosclerose: Acesso Aberto

Abstrato

Advanced Carotid Atherosclerosis and the Risk of Subsequent Major Cardiovascular Events: Carotid Ultrasound Study

Galal E. Nagib Elkilany1*, Mohammed Elmahal2, Amena Elsaady3, Jaipaul Singh4, Petras Lohana5, Rajeev Gupta6, Madian Abdelrahman7 andSherif Baath Allah8

Very little is known about the role of atherosclerotic carotid plaque morphology, vulnerability, and Total Plaque Area (TPA) in the development of Major Cardiovascular Events (MCVE). Aim of this study: To assess the role of carotid atherosclerosis and the plaque morphology in the prediction of MCVE.
Importance of the study: A better understanding of the role of detection of atherosclerosis and unstable plaque morphology can help to improve strategies for prevention of Acute Cardiovascular Events (ACVE) worldwide. Methods: This study analyzed the medical records of 452 patients with 2.5-years follow-up. The primary outcomes were the composite of first occurrence of stroke, cardiovascular death, and Acute Coronary Syndromes (ACS) hospitalization.
Results: The results show that carotid atherosclerosis was present in 44% of patients (n=103) and this was associated with increasing conventional cardiovascular risk factors and extent of symptomatic vascular disease. During 2.5 years
follow-up, 10% of patients experienced ≥ 2 MCVE. After adjustment for cardiovascular risk factors, the risk of ACS and stroke increased by 23% (95% Confidence Interval [CI]), and 45% (95% confidence interval), respectively in patients with carotid ultrasonic (US) evidence of advanced carotid atherosclerosis in comparison to control (P<0.001). The relative increase of cerebrovascular events was 22% in patients with carotid US evidence of vulnerable plaque morphology versus
benign morphology. The high risk for all-cause and cardiovascular death of these patients remained significant after adjustment for various established cardiovascular risk factors in multivariable regression analysis (adjusted hazard ratio
Conclusion: It is concluded that carotid TPA and features of vulnerability were associated with an increased risk of MCVE.